I'm sure a good number of you saw this article in the July edition of Seminars in Radiation Oncology: The future of radiation oncology: the evolution, diversification, and survival of the specialty. Zietman A. Semin Radiat Oncol. 2008 Jul;18(3):207-13. Zietman's article was, for me (although only a trainee), a canary-in-the-coal mine wake-up call regarding the future of a specialty that many of us love. The most fascinating aspect of the piece was his argument for possible long-term strategies to avoid clinical irrelevance, namely the idea of the radiation oncologist as an interventionalist; performing chemoembolization, radioembolization, in addition to our current tasks. This has obvious appeal for a variety of reasons (we already carry out interventional procedures such as brachytherapy; like interv. cardiologists, we have clinical knowledge regarding the disease on which the intervention is focused,etc,etc). Zietman mentions that the ABR is willing to consider individual requests by training institutions to test-pilot the above idea. The HROP program seems ideally suited to such a task--with its multi-institutional setting, huge clinical volume, varied expertise, and guaranteed, continuous year of research; imagining current residents using the research year as a first year "fellowship" in diagnostic radiology, followed by an additional year subsequent to completion of RadOnc in the interventional aspects of treatment, doesn't seem far fetched. Ultimately, one can envision training in interventional oncology integrated into RadOnc residency (and available to radiologists as part of a fellowship), but clearly some sort of bridge program would be needed to train this first generation of sub-specialists. My questions are these (perhaps Stephanie can weigh in here): 1) Where is this idea currently? Has HROP made any efforts to realize it? 2) If so, are any current residents pursuing it? 3) Are any other institutions taking up the idea? Thanks!